LiverMultiScan for graft assessment in children post transplant
Research type
Research Study
Full title
LiverMultiScan for the assessment of graft fibrosis in children post liver transplant
IRAS ID
93348
Contact name
Emer Fitzpatrick
Contact email
Sponsor organisation
King's College London
Duration of Study in the UK
0 years, 11 months, 30 days
Research summary
Liver transplantation is the accepted standard of care for most paediatric patients with end-stage liver disease. With the improvement in surgical techniques, intensive care and better understanding of immunosuppressive medication, medium term survival is now excellent. The focus now shifts to maintaining good graft function in the long term. Several studies have demonstrated that graft fibrosis and inflammation are almost universal at 5 to 10 years post-transplantation. This is of concern, as graft loss may be the eventual outcome. The inflammation and fibrosis are potentially reversible with modification of immunosuppression, however these changes are largely silent and detected only with liver biopsy. However, liver biopsy is not without its complications and there is a need for a less invasive method of assessment.
The main aim of this study is to develop and evaluate a novel MRI technique LiverMultiScan for the detection of graft inflammation and fibrosis in children post-transplantation. We aim to recruit children who are 5 or 10 years post-transplantation and who are asymptomatic with normal liver function tests. These children will undergo surveillance biopsy, which will be performed as a routine by the hepatologist. We propose to undertake an MRI scan using a specially designed protocol in children who can tolerate it without sedation. We aim to develop a score (PedLIF) which correlates to degree of inflammaiton / fibrosis on biopsy. We will also compare the utility of Transient elastography and serum biomarkers of inflammation / fibrosis. Non-invasive methods of measuring fibrosis/ inflammation will potentailly allow better on-going assessment of graft function. Early identification of graft injury would potentially lead to successful intervention and thus preservation of the graft with modification of immunosuppression.
REC name
London - South East Research Ethics Committee
REC reference
15/LO/1258
Date of REC Opinion
25 Aug 2015
REC opinion
Favourable Opinion